Canada’s particle physics laboratory TRIUMF is making a push to be a future world leader in the production of a special radioactive isotope nicknamed the “rarest drug on Earth,” which can deliver devastating amounts of energy to single cancer cells, without harming nearby tissue.

(( Note : TRIUMF is where the BCCA got the radioactive molecules for my own PET scan !!! ))

Ontario researchers say they have discovered how bacteria become resistant to antibiotics, a finding they say could help combat the growing problem.

Maikel Rheinstadter, a physics professor with McMaster University in Hamilton, and Andree Khondker, an undergraduate biochemistry student, said they found bacteria fight off antibiotics by stiffening their cell membranes and changing the barrier’s electrical charge, becoming a less attractive target to the drugs.

WEDNESDAY, Feb. 27, 2019 (HealthDay News) -- Young adults are increasingly developing colon cancer -- and it's often diagnosed at a late stage, after they've seen several doctors and been misdiagnosed, a new survey shows....

In all, 71 percent were diagnosed with more-advanced stage 3 or 4 cancer.

The authors review the current evidence regarding the adjuvant treatment of localized colon cancer to facilitate the selection of the appropriate therapy. No adjuvant treatment is needed for stage I and dMMR/MSI II colon cancer. For pMMR high-risk stage II colon cancer, adjuvant treatment is recommended with fluoropyrimidines. The recommended duration of adjuvant treatment for stage III colon cancer is 3 months for T3N1 and 6 months for T4 and/or N2. Targeted agents should be considered among appropriate patients.

Future areas of research include subgroups of patients who may benefit from specific treatments, new treatment settings, and guiding treatment using ctDNA.

Stereotactic ablative radiation therapy (SABR) for recurrent oligometastatic cancer is a feasible and tolerable treatment option, according to a phase 2 study published in the January issue of the International Journal of Radiation Oncology, Biology, Physics."In this study, for patients with stage IV disease, we have a treatment paradigm that can result in long-term survival while maintaining overall quality of life," senior author Dwight E. Heron, M.D., said in a statement. "We had a sense this was the case from retrospective data, but the addition of prospective data is very convincing."

This nationwide cohort study was designed to evaluate the predictive value of various alarm symptoms in the diagnosis of colorectal cancer among healthy adults aged ≥40 years. The symptom with the highest positive predictive value (PPV) and positive likelihood ratio was rectal bleeding. The PPVs were higher in those aged >75.

Most colorectal cancer alarm symptoms have low PPV, particularly in younger people. Rectal bleeding had the highest PPV. Future public health initiatives to increase early diagnosis of colorectal cancer should target older people and those with rectal bleeding.

Many patients with young-onset colorectal cancer (CRC), diagnosed at age 20 to 49 years, are initially misdiagnosed, according to research to be presented at the annual meeting of the American Association for Cancer Research, to be held from March 29 to April 3 in Atlanta.

"Young people need to be aware that colorectal cancer can happen at any age and it is not a disease of old people," Yarden said in a statement. "Everybody should listen to their body and, if it doesn't feel right, go to the doctor to be tested."

MONDAY, March 11, 2019 (HealthDay News) -- Onset of colorectal cancer (CRC) in adults younger than 50 years is distinct from onset in patients aged 50 years or older, according to a study published online March 11 in Cancer.....

The researchers found that compared with patients aged 50 years or older, early-onset patients were more likely to have microsatellite instability, synchronous metastatic disease, primary tumors in the distal colon or rectum, and fewer BRAF V600 mutations. Compared with other patients younger than 50 years, those aged 18 to 29 years had fewer adenomatous polyposis coli (APC) mutations and an increased prevalence of signet ring histology (odds ratios, 0.56 and 4.89, respectively). Consensus molecular subtype 1 (CMS1) was the most common subtype in patients aged younger than 40 years; CMS3 and CMS4 were uncommon. CMS2 was relatively stable across ages. The odds of mucinous or signet ring histology were increased, and odds of APC mutations were decreased in early-onset patients with inflammatory bowel disease (odds ratios, 5.54 and 0.24, respectively)....

This phase IIa study was designed to evaluate the activity of pertuzumab and trastuzumab in patients with HER2+ metastatic colorectal cancer. The objective response rate was 32%, with 1 complete and 17 partial responses seen in 57 patients. The treatment combination was generally well-tolerated. Grade 3–4 treatment-emergent adverse events, usually hypokalemia or abdominal pain, were seen in 37% of patients.

The combination of pertuzumab plus trastuzumab may be a useful therapeutic option in patients with treatment-resistant HER2+ metastatic colorectal cancer.

There’s a growing belief that a blood test could act as a crystal ball in predicting a person’s necessity, response, and ultimate outcome to cancer treatment.

According to BC Cancer researchers, blood can contain tiny fragments of DNA from an individual’s cancer and those fragments provide incredible insight into the patient’s journey. Imagine a simple blood test guiding your treatment: pointing to the right drugs, staying one step ahead of the cancer, and effectively breaking it down.

These miniscule fragments are called circulating tumour DNA, or ctDNA for short. And, BC Cancer’s world-leading breast cancer team is embarking on a two year study looking at the benefits of introducing ctDNA testing in the clinic ...

Colorectal cancers diagnosed in early adulthood are genetically and clinically distinct from, and likely more aggressive than, colorectal tumors diagnosed at older ages, according to the results of a large analysis of four patient cohorts. The findings were published in the journal Cancer.

Among patients younger than 50 years old, colorectal tumors are significantly more likely to harbor particular genetic mutations and to have certain histologic features than are those among older patients, including synchronous metastases, microsatellite instability, and fewer BRAF V600 mutations, the researchers reported.

“Both BRAF V600 mutations and microsatellite instability are important molecular alterations in colon cancer because they are both things that we can target with specific treatments, and our study helps highlight which groups of patients may be more likely to have these targetable alterations,” said senior study coauthor Jonathan M. Loree, MD, of BC Cancer in Vancouver, British Columbia, Canada.

A trial of an antigen-specific cancer vaccine known as tecemotide failed to improve outcomes over placebo in patients with colorectal cancer and liver metastases. Though there was a biological rationale for targeting the MUC1 antigen, this trial suggests that it may not be a suitable target in this malignancy.

The combination of durvalumab and tremelimumab yielded improved survival over best supportive care in patients with advanced refractory colorectal carcinoma, according to a new phase II trial. This was among the first trials showing that an immunotherapy combination can benefit a population that was unselected for microsatellite instability.

“At the time of initiation of our study, immune checkpoint blockade has not shown activity in refractory colorectal cancer other than [in] those with mismatch repair deficiency,” said Eric X. Chen, MD, PhD, of the University of Toronto. Chen presented results of the Canadian Cancer Trials Group CO.26 trial at the American Society of Clinical Oncology (ASCO) 2019 Gastrointestinal Cancers Symposium, held January 17–19 in San Francisco (Abstract 481).

The XELAVIRI trial failed to demonstrate the noninferiority of a sequential escalation treatment strategy with fluoropyrimidines, irinotecan, and bevacizumab compared with initial combination therapy in patients with untreated metastatic colorectal cancer.

However, researchers led by Dominik Paul Modest, MD, of Comprehensive Cancer Center, University of Munich, Germany, wrote that although noninferiority was not demonstrated, it could also not be ruled out.

“A critical aspect of the current study consists of the observation that sequential escalation of treatment – that is, the addition of irinotecan in arm A was only performed in a minority (37.7%) of patients,” Modest and colleagues wrote in The Journal of Clinical Oncology. “Given the median treatment duration of 7.4 months observed in the sequential treatment arm, many patients seemingly discontinued treatment without progression and therefore did not rely on the salvage escalation within the foreseen time interval of first-line therapy.”

Negative colonoscopy results among patients with average risk for colorectal cancer were associated with a lower risk for colorectal cancer diagnosis and death more than a decade after the test compared with patients who had no screening, a retrospective study found.

“Current guidelines recommend a 10-year rescreening interval after a negative colonoscopy result…this recommendation is supported by modest empirical data,” wrote Jeffrey K. Lee, MD, of Kaiser Permanente San Francisco, and colleagues. “Our findings can inform guidelines recommendations for rescreening and future studies to evaluate the costs and benefits of earlier vs later rescreening intervals.”